Date ______Patient’s Name ______Formula Name ______Notes ______

Ingredients Dose Ingredients Dose Ingredients Dose Ingredients Dose Amino Acids NMN Sea Salt Lowat Acetyl L-Carnitine PABA Selenium Lutein Alpha Ketoglutarate Pantothenic Acid Strontium Citrate Lycopene DL-Phenylalanine Pyridoxal-5-Phosphate Vanadium Malic Acid Glycine Pyridoxine HCL Vanadium Citrate Melatonin L-Alanine Riboflavin-5- Phosphate Zinc Carnosine MicroPQQ L-Arginine Sulbutiamine Zinc Gluconate OptiMSM L-Asparagine Thiamine Mononitrate Zinc Glycinate PEA (Palmitoylethanolamide) L-Aspartic Acid Vit. A (as Beta Carotene) Zinc Picolinate PharmaGABA L-Carnitine Tartrate Vit. A (as Vit. A palmitate) Phosphatidyl Choline L-Carnosine Vit. C (as Ascorbic Acid) Nutraceuticals Phosphatidyl Serine L-Citrulline Vit. C (as Sodium Ascorbate) 5-HTP Plant Sterols L-Glutamine Vit. D (as Cholecalciferol) Acticissus Policosanol 95% L-Glutathione Vit. E (as d-alpha tocopherol) Adrenal Concentrate Pregnenolone L-Histidine Vit. E (as mixed tocopherols) AG4400 MctSMART® Vegan MCT Primavie Shilijit Extract L-Isoleucine Vit.C (as Ascorbyl Palmitate) Alpha Lipoic Acid Psyllium Husk Powder L-Leucine Vitamin K1 Astaxanthin Pterostilbene L-Lysine Vitamin K2 Beef Liver Powder Red Yeast Rice L-Methionine Beta - Glucan 85% Relora L-Ornithine Minerals Betaine Anyhydrous(TMG) Ribonucleic Acid (RNA) L-Phenylalanine Boron Betaine HCL SAMe L-Proline Calcium BHB Bioflavonoids Sunflower Lecithin L-Serine Calcium Citrate Bovine Cartilage (BioCartilage) Sytrinol L-Theanine Calcium Disodium EDTA Broccoli Powder Theacrine L-Threonine Calcium Glycinate Bromelain (2400 GDU) Zeaxanthin L-Tryptophan Chromium Polynicotinate Calcium D-Glucarate L-Tyrosine Copper Chondroitin Herbs L-Valine DiMagnesium Malet Citric Acid Agaricus Extract L-Valine Iodide Citrus Pectin Aloe Vera Gel L-Valine Iron Bisglycinate CoQ10 Artichoke Iron Ferrochel (Ferrous Bisgly- Creatine Ashwagandha Vitamins Lithium DHA (Omega-3 algae) Astragulus Benfotiamine MagnaPower (creatine) DHEA Bacopa Biotin Magnesium BHB DIM Banaba Leaf Choline Magnesium BisGlycinate DMAE Bitartrate Beet Root Citicoline Magnesium Citrate Ellagic Extract 90% Berberine HCL D-Calcium Pantothenate Magnesium Glycinate Glutamine GABA Bergamot (Citrus bergamia) 40% Folate (as Folic Acid) Magnesium L-Threonate Gamma Oryzanol Billberry Folate (as Quatrefolic) Magnesium Taurinate Glucosamine BioPerine Inositol Hexanicotinate Manganese Guar Gum Bitter Melon Inositol Hexaphosphate Manganese Aspartate 17% Guggulsterones Black Cohosh Extract Methylcobalamine B12 Microcrystalline Hydroxyapatite Hyaluronic Acid Blueberry Extract Powder Mixed Carotenoids Molybdenum Hydrolyzed Collagen Boswellia Niacinamide Potassium Citrate Lepticore Burdock Root

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REVISION:9/25/19 Ingredients Dose Ingredients Dose Ingredients Dose Ingredients Dose Camu camu Green Coffee Bean Extract 50% Oregon Grape (Berberis aquifolium) Vinpocetine 99% Cat's Claw Green Tea Parsley Leaf Powder Witch Hazel Extract Catalase Gymnema Passionflower Yucca Celery Seed Extract Gynostemma (Jiaogulan) Pau D'Arco Powder Chaga Gold Hawthorn Pine Bark Extract Flavoring Chamomile Hops Pomergranate Lemon-Lime Flavor Chaste Tree Berry Extract Horsetail 7% Silica Quercetin Natural Chocolate Flavor Powder Chlorella Huperzia Serrata Red Clover Natural Strawberry Flavor Powder Cilantro Leaf HydroCurc Curcumin Reishi Natural Vanilla Bean Flavor Cinnamon Indole-3-Carbinol (I3C) Resveratrol Orange Flavor Clove Extract Kudzu Rhodiola Cocoa Powder Larch Arabinogalactan Rhubarb Protien Powder Cordyceps Lavender Rosemary Hemp protein powder Dandelion Lemon Balm Saw Palmetto Pea protein powder Dyglofit Lepticore Schisandra Berry Rice protein powder Eleuthero Licorice Shatavari Extract Whey protein powder Evothin (Evodiamine 98%) Luteolin Shiitake Flax Seed Magnolia 2% Shilajit Extract (PrimaVie®) Forslean Colues Forskohlii Maitake Skullcap Fucoidan Marshmallow Root Powder Spirulina Garlic Milk Thistle Sunphenon XLB-100 Ginger Mimosa pudica Tart Cherry Powder Ginkgo Monk Fruit Extract Tongkat Ali Goat’s Rue Extract Mucuna 95% L-Dopa Tribulus Goldenrod Extract Powder 4:1 Nettle Root Turkey Tail Gotu Kola Noni PE 5:1 (Organic) Turmeric Grape Seed Olive Leaf Uvi Ursi Grapefruit Seed Extract Oregano Valerian Root

Order online at www.personalized-nutrients.com or 844.634.4146

REVISION:9/25/19